Spine Condition
Sciatica
Pain down the leg — almost always treatable without surgery.
Sciatica is the term for pain that radiates along the path of the sciatic nerve — from the lower back, through the buttock, and down one leg. It's a symptom, not a diagnosis: the underlying cause is usually a herniated disc, spinal stenosis, or piriformis syndrome compressing the nerve root. The good news is that most sciatica resolves without surgery within 4–12 weeks. Our spine team in Plano starts with the least invasive treatment that addresses the root cause.
Understanding the Condition
What is Sciatica?
The sciatic nerve is the largest nerve in the body. It originates from the lumbar and sacral nerve roots (L4–S3) in the lower back, runs through the buttock and down the back of the leg, and branches into the smaller nerves that supply the calf and foot. When any of those nerve roots is irritated or compressed, the pain pattern travels along the entire nerve path — the classic 'shooting pain' from buttock to foot.
Sciatica is most often caused by a herniated lumbar disc pressing on a nerve root, but it can also be caused by spinal stenosis, spondylolisthesis, piriformis muscle spasm, or rarely, a tumor or infection. Identifying the underlying cause is what determines the treatment plan.
Common Causes
- Herniated lumbar disc (most common — usually L4-L5 or L5-S1)
- Lumbar spinal stenosis
- Spondylolisthesis (vertebra slipping forward)
- Piriformis syndrome (muscle in the buttock irritating the nerve)
- Pregnancy-related pelvic pressure
- Rare: tumor, infection, or hematoma compressing the nerve
Common Symptoms
- Sharp, burning, or shooting pain from the lower back through one buttock and down the leg
- Numbness or tingling in the leg, calf, or foot
- Weakness in the leg or foot (e.g., difficulty lifting the foot)
- Pain that worsens with sitting, coughing, or sneezing
- Pain typically affects only one leg
- Severe cases: foot drop, saddle numbness, bladder/bowel changes (medical emergency)
When to Seek Care
When Should You See a Specialist?
See a specialist if sciatica hasn't improved after 4–6 weeks of conservative care, if pain prevents sleep or normal activity, or if you have progressive weakness or numbness. Sudden foot drop, severe weakness, or any saddle-area numbness or bladder change is a medical emergency requiring immediate ER evaluation.
Treatment Options
How We Treat Sciatica
We always begin with the least invasive treatment that's likely to work for you. Surgery is reserved for cases where conservative care has been given a fair trial — or when the situation truly requires it.
Conservative (Non-Surgical) Care
- Physical therapy with directional preference exercises
- Anti-inflammatory medications
- Image-guided lumbar epidural steroid injections
- Selective nerve root blocks for diagnostic clarity
- Activity modification — avoid prolonged sitting
- Targeted muscle relaxants for accompanying spasm
Surgical Options
- Microdiscectomy — for sciatica caused by a herniated disc; outpatient, 2–4 week recovery
- Lumbar decompression — when stenosis is the cause
- Decompression with fusion — when instability is also present
Recovery & Outlook
What to Expect After Treatment
About 80–90% of sciatica resolves with conservative care alone within 6–12 weeks. For patients with severe, persistent pain or significant weakness, microdiscectomy provides immediate relief in roughly 90% of properly selected cases.
Meet Your Team
Specialists Who Treat Sciatica
Sciatica — Frequently Asked Questions
Related Conditions
You May Also Want to Read About
Herniated Disc
When disc material pushes out and presses on nearby nerves, causing pain, numbness, or weakness.
Spinal Stenosis
Narrowing of the spinal canal that puts pressure on the spinal cord and nerves.
Low Back Pain
The most common musculoskeletal complaint, with causes ranging from muscle strain to structural issues.
Radiculopathy
Compressed or irritated nerve roots causing pain, weakness, or numbness in the extremities.
Get Expert Help for Sciatica
Our specialists can diagnose your condition and design a personalized treatment plan that gets you back to the life you love.